Research

From crisis to sustainable development: lessons from the Ebola outbreak

who.int - May 10, 2015

. . . three changes will do the most to improve the world’s collective defence against the infectious disease threat.

First, invest in building resilient communities and well-performing health systems that integrate public health and primary health care. Ideally, health systems should aim for universal health coverage, so the poor are not left behind. This requires new thinking and a new approach to health development.

Second, develop the systems, capacities, and financing mechanisms needed to build surge capacity for responding to outbreaks and humanitarian emergencies.

Third, create incentives for R&D for new medical products for diseases that primarily affect the poor. A fair and just world should not let people die for what boils down to market failure and poverty.

These three things also fit well with the coming agenda for sustainable development that seeks to distribute the benefits of economic growth more evenly and respects our planet’s fragile resources.

EUREKALERT                                                                           April 22, 2015
UNIVERSITY OF LIVERPOOL -- 
The first donations of plasma, from survivors of the Ebola epidemic in Sierra Leone, have been received by an international research team working to help tackle current and future disease outbreaks in West Africa.

The team, led by scientists at the University of Liverpool and colleagues at the College of Medicine and Allied Health Services, Ministry of Health, Sierra Leone, is investigating how plasma from Ebola survivors could help treat patients with the disease at the Ebola Treatment Unit, run by the 34th Regiment Military Hospital group in Freetown.

Dr Calum Semple, from the University's Institute of Child Health, and his collaborators developed a convalescent plasma protocol in readiness for an outbreak, such as Ebola, as part of the outbreak preparatory work of the International Severe Acute Respiratory and Emerging Infection Consortium.

The study is one of several being supported by the Wellcome Trust's platform for evaluating experimental Ebola therapeutics in West Africa.

Read complete story.
http://www.eurekalert.org/pub_releases/2015-04/uol-esd042215.php

PLOS  Current Outbreaks  by Nadia Wauquier and others                                             April 20, 2015

The initial steps of emergence and spread of a virus are critical in the development of a potential outbreak and need to be thoroughly dissected and understood in order to improve on preventative strategies. In the current West African outbreak of EVD, a unique index case has been identified, pinpointing the geographical origin of the epidemic in Guinea.

Herein, we provide an accounting of events that serve as the footprint of EVD emergence in Sierra Leone and a road map for risk mitigation fueled by lessons learned....

...Continuous active surveillance is needed and must be organized by specialized centers joined in local, regional, and international networks. Surveillance centers must be connected to public health systems and also to research teams for increased understanding and awareness to permit identification and implementation of rapid intervention strategies....

Read complete study  and see maps.

PLOS MEDICINE   by Ben Cooper and others                                                             April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

Read complete study.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815